Objective To evaluate the curative effect of stent angioplasty for treatment vertebral basilar artery stenosis. Methods 34 patients with vertebral basilar artery stenosis diagnosed by DSA were treated with cerebral angioplasty and stenting(CAS ) operation by flexible balloon expandable stents. Results 36 stents were placed in 34 patients. The achievement ratio of operation was 100%. All stenosis showed by DSA were successfully improved without complications.The mean stenosis rate of preoperation and postoperation were (78.3?6.2)% and (3.6?4.2)% respectively. During the further follow up period of 6～38 months, clinical symptoms were disappeared in 31 patients, relieved in 2 patients, recurred in 1 patient.There were no vertebro-basilar system transient ischemic attack and brain infarction onset in those patients.Conclusion Stent angioplasty is safe and effective in the treatment of symptomatic vertebral artery stenosis.

The analytical chemistry is the specialized fundamental course of medical laboratory major.To the higher vocational students,it is an experiment operation technique,so to introduce the pattern based on the work process curriculum is helpful to the deconstruction and reorganization of analytical chemistry curriculum,and can stimulate students'study interest enormously and get good teaching effect.

Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.

BACKGROUND: Non-invasive vascular ultrasound is used to assess in tima-media thickness (IMT) and atheromatous plaque, of which the result is better correlated to that of pathological examination. OBJECTIVE: Non-invasive vascular ultrasound was used to assess the hemodynamical changes of external and internal carotid in hypertensive elders, so as to investigate the relationship between pulse pressures, left ventricular mass index (LVMI), vascular resistance index (VRI) and shearing ratio. DESIGN: Randomized, controlled, correlative analyzedstudy. SETTING: Ultrasound Department of Affiliated Hospital of Jiangshu University. PARTICIPANTS: Totally 54 hypertensive elders, including 33 males and 21 females, were recruited from the Ultrasound Department of Affiliated Hospital of Jiangshu University, from September 30th 2000 to March 30th 2002. Meanwhile 26 normotensive elders (systolic pressure ＜ 130 mm Hg and/or diastolic pressure ＜ 85 mm Hg), including 16 males and 10 females, were selected as controls, METHODS: Color duplex blood flow imaging technique was used to assess the left ventricular end-diastolic diameter (LVEDD) and the interventricular septum thickness (IVST), so as to calculate the LVMI. The insiddiameter of bilateral common carotid artery (CCA) and internal carotid,IMT, the systolic peak flow velocity and resistance index were measured in order to calculate the vascular shearing ratio and atheromatous plaque index,moreover arterial pressure, LVMI, as well as resistance index and shearing ratio were subjected to linear correlative analysis,of which the results were compared with that of control group. MAIN OUTCOME MEASURES: ① Pulse pressure, LVMI and atheromatous plaque index of CCA. ② The inside diameter of bilateral CCA and internal carotid, IMT and the systolic peak flow velocity and resistance index were measured in order to calculate the atheromatous plaque index and maximum vascular shearing ratio. RESULTS: According to the experimental objective,data of all 80 cases were analyzed without loss. ① The pulse pressure and LVMI, the incidence of atheromatous plaque and plaque index of CCA in hypertensive elder group were obviously higher than that of control group [(64.36±7.44) mm Hg,(45.78±8.72) mm Hg; (131.47±18.73) g/m2, (83.28±12.34) g/m2; 5.62 ±1.78,3.44±1.10; 66.7％, 23.1％, (x2=13.37, t=5.730-13.234, P ＜ 0.01)]. ② The inside diameter of bilateral CCA and internal carotid, IMT and resistance index in hypertensive elders were significantly higher than that of control group [CCA: (8.96±1.20) mm, (8.08±0.96) mm; (1.28±0.88) mm, (0.91±0.17) mm;0.75±0.05, 0.69±0.06; ICA: (6.82±1.12) mm, (5.72±0.92) mm; (1.06±0.17) mm,(0.76±0.15) mm; 0.70±0.07, 0.64±0.06, t=2.872-10.850, P ＜ 0.01], but the systolic peak flow velocity and shearing ratio were markedly lower than that of control group [CCA: (47.44±12.85) cm/s, (60.20±14.32) cm/s;(225.78 ±95.76)/s, (300.26 ±110.42)/s. ICA: (41.22 ±10.18) cm/s,(48.64±11.58) cm/s; (268.54±112.56)/s, (324.52±121.42)/s, t=2.872-10.850, P ＜ 0.01]. ③ The pulse pressure, LVMI, the resistance index of CCA and ICA and shearing ratio were linearly correlated (r=0.30-0.36, P ＜ 0.05). CONCLUSION: Pulse pressure and LVMI were found increased in hypertensive elders, together with carotid vessels dilated, IMT and resistance index increased, as well as shearing ratio decreased, atheromatous plaque formed, vascular stiffness increased, which resulted in consequently decrease of vascular compliance.

Objective To investigate the association among oligospermatism,azoospermatism in male sterility patients and micro-deletion in AZF gene of Y chromosome and to establish a integrate clinical diagnostic method for screening micro-deletion in AZF gene in Chinese.Methods PCR method was used to detect micro-deletion in AZF gene in 62 oligospermatism and azoospermatism patients and 20 normal male controls.Results 13.64%(6/44) of oligospermatism patients and 22.22%(4/18) of azoospermatism patients presented micro-deletion.However,micro-deletion was not found in 20 normal male controls.Furthermore,micro-deletion occur mostly in AZFc region.Conclusion Micro-deletion of AZF gene from Y chromosome is one of the major risks for oligospermatism and azoospermatism.

Objective:To understand the iodine content of edible salt in residents of Xinjiang Production and Construction Corps (referred to as Corps), and provide scientific evidence for prevention and treatment of iodine deficiency disorders.Methods:According to the requirements of the "National Iodine Deficiency Disorders Surveillance Program" form 2015 to 2019, in accordance with the principle of random sampling, one regiment from each of the five directions of east, west, south, north and center in the Corps was selected, and four companies were selected from each regiment. Edible salt samples from the homes of 15 residents in each company were collected, and salt iodine content was quantitatively tested and the test results were analyzed.Results:From 2015 to 2019, 21 028 household salt samples were collected, qualified iodized salt were 20 204, non-qualified iodized salt were 712, non-iodized salt were 112, iodized salt coverage rate was 99.47% (20 916/21 028), iodized salt qualified rate was 96.60% (20 204/20 916), qualified iodized salt consumption rate was 96.08% (20 204/21 028). The average salt iodine content was (27.72 ± 4.81) mg/kg. From 2015 to 2019, the iodized salt coverage rates in the whole Corps were all > 95%, and the iodized salt qualified rates and the qualified iodized salt consumption rate were all > 90%. Among the 14 divisions of the Corps, iodized salt coverage rates were all > 95%, except for the 12th and 14th divisions, where the iodized salt qualified rates and qualified iodized salt consumption rates were < 90%, all other divisions were > 90%.Conclusions:Iodized salt coverage rate, iodized salt qualified rate and qualified iodized salt consumption rate have all reached the national standard for eliminating iodine deficiency disorders from 2015 to 2019, however, non-iodized salt exists in some areas, and the qualified iodized salt consumption rate is low. We should strengthen monitoring of iodized salt in key areas and promote health education, consolidate and maintain achievements in eliminating iodine deficiency disorders.

The psychological health problems of the disabled elderly in China are closely related to physical diseases. Through combing the opening of psychological care services in the pilot cities of long-term care insurance in China, it is revealed that the current pilot cities do not pay much attention to psychological nursing services, the evaluation of psychological nursing needs is absent, and the implementation regulations of psychological nursing services are not perfect. Pilot cities should strengthen psychological care services for the disabled elderly; develop an evaluation system compatible with psychological care services; improve and implement psychological care services; developing information systems that match the needs of psychological care services to ensure the linkage of data in the transition between long-term care and medical needs; and the clients and service providers should cooperate to jointly promote the sustainable development of long-term care insurance psychological care services.

Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.

Objective:To analyze the correlation between the grouping and weighting of two sets of disease combination systems, namely diagnosis-related groups(DRG) and diagnosis-intervention packet(DIP), and to establish a multidimensional analysis and evaluation mode by applying DRG, DIP, and clinical pathway to guide the standardized diagnosis and treatment and management of disease types.Methods:DRG grouping and DIP simulation full enrollment were applied to patients discharged from a tertiary Grade A general hospital in 2019. The correlation analysis between DRG, DIP, and clinical pathway inclusion(entry), correlation analysis between relative weight of DRG group and DIP standard score, and correlation analysis between clinical pathway entry and cost structure of the two disease groups were conducted by using chi-square test, Pearson correlation analysis, t-test, structural change value, degree of structural change, and incremental contribution rate. Results:Among the 130 395 patients, 41 460 cases entered the clinical pathway, 127 535 cases were enrolled in DRG, and 104 227 cases were enrolled in DIP. There was a correlation between the enrollment of DRG, DIP, and clinical pathway( P<0.05), and there was also a correlation between the relative weight of DRG groups and the enrollment of clinical pathway. The relative weight of the DRG disease group was positively correlated with the DIP standard score( r2=0.761 7, P<0.001). There was a significant difference in hospitalization costs between patients with and without clinical pathway access for some diseases( P<0.05), and different cost categories had different impacts on the total costs. Conclusions:The weight assignment and value orientation of DRG and DIP disease types are consistent, and the multi-dimensional fusion evaluation mode for DRG-DIP-clinical pathway is feasible. The correlation analysis of DRG, DIP, and clinical pathways can serve as the basis for disease classification and cost structure evaluation, which could help to carry out hospital′s refined management and optimize disease structure.

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.